Reviews Of Intervention Effectiveness Research Articles

Review of Intervention Effects on Activity and Participation in Adults with Brain Injury

<h3>Objective(s)</h3> To determine which intervention elements may be most strongly associated with improvements in activity and participation among adults with acquired brain injury. <h3>Data Sources</h3> Articles were selected from PubMed and PsycINFO/Ovid. <h3>Study Selection</h3> Inclusion criteria: 1) RCT; 2) examined interventions in adults with brain injury; 3) included an activity or participation outcome measure. Exclusion criteria: 1) examined a pharmacological intervention. <h3>Data Extraction</h3> We first classified intervention elements into categories. Patterns of effect sizes were examined for each category of intervention element. We then examined effect sizes based on time of follow-up and type of outcome (home or community activities). <h3>Data Synthesis</h3> The search resulted in 39 included articles. We identified 11 categories of intervention elements, and each was associated with a wide range of effect sizes. Across all outcomes, metacognitive interventions (d=.08-2.9, 32.4% large effect sizes) and daily life skills interventions (d=.00-1.86, 18.8% large effect sizes) were the most strongly associated with improvements in activity-based outcomes. Cognitive training interventions were also associated with improvements in home activity performance (d=.04-1.76, 0% large effect sizes, 69.3% moderate effect sizes), while social skills training was associated with improvement in community activity performance (d=.00-.98, 10.7% large effect sizes). Physical activity interventions were least strongly associated with activity-based outcomes (d=.00-.35, 0% large or moderate effect sizes). Most studies examined results within 6 months of study admissions, and effect sizes beyond 6 months appeared smaller. <h3>Conclusions</h3> Interventions targeting impairments alone appear unlikely to influence activity-based outcomes, whether at home or in the community. Rather, interventions that include elements of explicit strategy use and task-specific training or practice may be necessary. Few of the included outcome measures comprehensively examined participation, but rather simply performance of community activities. Thus, the influence of these interventions on participation itself remains unclear. <h3>Author(s) Disclosures</h3> The authors have no conflicts of interest to disclose.

Cochrane Effective Practice and Organisation of Care (EPOC) Qualitative Evidence Syntheses, Differences From Reviews of Intervention Effectiveness and Implications for Guidance

Systematic reviews of qualitative research (‘qualitative evidence syntheses’) are increasingly popular and represent a potentially important source of information about people’s views, needs and experiences. Since 2013, Cochrane has published qualitative evidence syntheses, and the Cochrane Effective Practice and Organisation of Care group has been involved in the majority of these reviews. But more guidance is needed on how to prepare these reviews in an environment that is more familiar with reviews of quantitative research. In this paper, we describe and reflect on how Cochrane qualitative evidence syntheses differ from reviews of intervention effectiveness and how these differences have influenced the guidance developed by the EPOC group. In particular, we discuss how it has been important to display to end users, firstly, that qualitative evidence syntheses are carried out with rigour and transparency, and secondly, that these quality standards need to reflect qualitative research traditions. We also discuss lessons that reviews of effectiveness might learn from qualitative research.

Self‐leadership: A meta‐analytic Review of Intervention Effects on Leaders’ Capacities

Leadership interventions are increasingly popular, but their effects on self‐leadership of leaders are largely unknown. The objective of the current study was to evaluate benefits of leadership interventions on leaders’ self‐leadership capacities. The search encompassed studies published between 1986 and 2019. Included were randomized controlled trials (RCTs), controlled before‐and‐after studies (CBA), before‐after studies without controls (BA), case studies, and qualitative longitudinal studies that examined potential effects of interventions on leaders' self‐leadership capacities. Primary outcomes attributable to self‐leadership theory and its strategies measured by validated instruments were extracted. A meta‐analysis was conducted for quantitative controlled studies with comparable primary outcomes. Eleven studies fulfilled the inclusion criteria, with a total of 571 participants in leadership positions. Eight quantitative studies, two RCT studies, four quasi‐experimental field studies with a pre‐post design (CBA), and two intervention case studies (BA), were included. Three qualitative studies evaluated a comparable form of leadership development. All studies showed positive but small to medium‐sized effects of leadership training on primary outcomes. Results of the review contribute to knowledge of the effectiveness of training for self‐leadership capacities of leaders and identified gaps where evidence remains limited. The findings tentatively suggest that leadership interventions could be beneficial for developing self‐leadership skills. Future studies should focus on content, frequency, and intensity of interventions. Mixed methods are strongly recommended.

PROTOCOL: Multiagency programmes with police as a partner for reducing radicalisation to violence.

Violent radicalisation is a complex problem, complicated by the lack of a clear terrorist profile and variation in the risk factors that predict violent extremism across individuals and groups (Campelo, Oppetit, Neau, Cohen, & Bronsard, 2018; Carlsson et al., 2020; Desmarais, Simons‐Rudolph, Brugh, Schilling, & Hoggan, 2017; Wolfowicz, Litmanovitz, Weisburd, & Hasisi, 2019). While models of understanding radicalisation vary (Borum, 2015; Christmann, 2012; Desmarais et al., 2017; Horgan, 2008; Koehler, 2017; Kruglanski, Belanger, & Gunaratna, 2019; Sarma, 2017), it is broadly defined as the process by which a person adopts extremist views and moves towards committing a violent act (Irwin, 2015; Jensen, Atwell Seate, & James, 2018). Radicalisation has been linked with individual and group engagement in terrorist attacks against innocent civilians (Wilner & Dubouloz, 2010), as well as individuals entering conflict zones to join formal extremist groups to engage in violent combat (Lindekilde, Bertelsen, & Stohl, 2016). As a result, radicalisation has become a key focus for counterterrorism and violence prevention interventions. The complex and varied nature of individuals' progression from radicalisation to violence presents challenges for designing and evaluating appropriate interventions and policy responses (Hafez & Mullins, 2015; Helmus et al., 2017; Horgan & Braddock, 2010; Horgan, 2008; Jensen et al., 2018; Kruglanski et al., 2019). This level of complexity has driven national counterterrorism policy agendas to adopt intersectoral and multiagency responses that aim to address various radicalisation processes and risks (Beutel & Weinberger, 2016). These multiagency responses often involve partnerships and collaborations between various different agencies and entities (Hardy, 2018), such as governmental agencies, private businesses, community organisations and service providers.

Cochrane Eyes and Vision: a perspective introducing Cochrane Corner in Eye.

In 1972, Archie Cochrane wrote "It is surely a great criticism of our profession that we have not organised a critical summary, by specialty or subspecialty, adapted periodically, of all relevant randomised controlled trials". The Cochrane Collaboration arose in response to Archie Cochrane's challenge. Cochrane Eyes and Vision aims to prepare and promote access to systematic reviews of interventions for preventing or treating eye conditions and/or visual impairment, and helping people adjust to visual impairment or blindness. To identify all relevant randomised controlled trials, Cochrane Eyes and Vision has a team of information specialists who develop search strategies to identify studies for inclusion in Cochrane reviews. Since 1997 we have published 266 protocols, 193 new reviews and 158 updated reviews. The majority of these are reviews of intervention effectiveness; three reviews are diagnostic test accuracy reviews. Overall 18% of reviews contain no trials, highlighting a potential evidence gap. We provide training, education and guidance to systematic review authors and work with clinical and patient partners to prioritise and disseminate reviews. In addition, Cochrane Eyes and Vision US satellite carries out critical methodologic research addressing topics relevant to producing high-quality reviews. We are partnering with the journal Eye to publish commentaries on selected Cochrane systematic review findings. This partnership will allow us to make high-quality evidence available to ophthalmologists and other practitioners, researchers, policy makers and patients.

Cochrane Qualitative and Implementation Methods Group guidance series—paper 3: methods for assessing methodological limitations, data extraction and synthesis, and confidence in synthesized qualitative findings

The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method implementation evidence. Choice of appropriate methodologies, methods, and tools is essential when developing a rigorous protocol and conducting the synthesis. Cochrane authors who conduct qualitative evidence syntheses have thus far used a small number of relatively simple methods to address similarly written questions. Cochrane has invested in methodological work to develop new tools and to encourage the production of exemplar reviews to show the value of more innovative methods that address a wider range of questions. In this paper, in the series, we report updated guidance on the selection of tools to assess methodological limitations in qualitative studies and methods to extract and synthesize qualitative evidence. We recommend application of Grades of Recommendation, Assessment, Development, and Evaluation–Confidence in the Evidence from Qualitative Reviews to assess confidence in qualitative synthesized findings. This guidance aims to support review authors to undertake a qualitative evidence synthesis that is intended to be integrated subsequently with the findings of one or more Cochrane reviews of the effects of similar interventions. The review of intervention effects may be undertaken concurrently with or separate to the qualitative evidence synthesis. We encourage further development through reflection and formal testing.

Issues in the incorporation of economic perspectives and evidence into Cochrane reviews

BackgroundMethods for systematic reviews of the effects of health interventions have focused mainly on addressing the question of 'What works?’ or 'Is this intervention effective in achieving one or more specific outcomes?’ Addressing the question 'Is it worth it given the resources available?’ has received less attention. This latter question can be addressed by applying an economic lens to the systematic review process.This paper reflects on the value and desire for the consideration by end users for coverage of an economic perspective in a Cochrane review and outlines two potential approaches and future directions.MethodsTwo frameworks to guide review authors who are seeking to include an economic perspective are outlined. The first involves conducting a full systematic review of economic evaluations that is integrated into a review of intervention effects. The second involves developing a brief economic commentary. The two approaches share a set of common stages but allow the tailoring of the economic component of the Cochrane review to the skills and resources available to the review team.ResultsThe number of studies using the methods outlined in the paper is limited, and further examples are needed both to explore the value of these approaches and to further develop them. The rate of progress will hinge on the organisational leadership, capacity and resources available to the CCEMG, author teams and other Cochrane entities. Particular methodological challenges to overcome relate to understanding the key economic trade-offs and casual relationships for a given decision problem and informing the development of evaluations designed to support local decision-makers.ConclusionsMethods for incorporating economic perspectives and evidence into Cochrane intervention reviews are established. Their role is not to provide a precise estimate of 'cost-effectiveness’ but rather to help end-users of Cochrane reviews to determine the implications of the economic components of reviews for their own specific decisions.